Zombie CSU (24 page)

One potential complication is that it’s going to take hospital staff a very long time before they think “zombie,” especially at the very beginning of an outbreak. On the upside, hospital staff are quite used to dealing with violent patients. They would not, as has been shown in some books and films, attack the patient if, for example, he started to bite. “The medical staff is there to try and save lives. It would never cross their minds to physically hurt someone on purpose for
any
reason,” insists Dr. Lukacs. “They would try their damndest to try and save this poor soul (do zombies even have souls?) at any cost. They would never consider injuring a patient just because he’s being violent. If that were the case, how many hyperactive patients from cocaine would make it to the hospital? Ever see
Scarface
? When Al Pacino is doped out of his mind on coke and gets riddled with bullets but still won’t go down? It’s a fairly realistic scenario to a certain point…these people don’t feel pain and think they are indestructible. Ask any police officer who has tried to subdue an unarmed violent crack-head. That’s what hospital staff would think they’re dealing with, and they would call in as many staff members as possible to restrain the person.”

Once the patient is secured and restrained to the bed, the next step is evaluation. “If the patient was presenting with the symptoms you’ve described,” says Grantham, “unusually low BP, low body temp, low pulse, etc.—then we’d kick into high gear. Anomalous symptoms of that level of severity are going to suggest a disease of some virulence. Once the staff had collected samples—blood, EKG, EEG, x-rays, etc—and these were in the lab we’d call in consults with specialists in each field, and we’d probably get someone from infectious disease there stat. The patient would be immediately quarantined and specialists would be called in, and at some point we’d be talking to the CDC.”

And what about the bitten guard?

“We would want to take a look at anyone who had come in contact with this person, and certainly someone with whom there had been a body fluid exchange.”

Dr. Chandra Singh, a surgical resident at the Salvator Mundi International Hospital in Rome. adds, “If the patient presented with gunshot wounds, then he would be rushed into surgery. Our surgical staff would take note of the atypical vitals and would call in specialists. It may be that the low vitals would be interpreted as a form of shock, in which case the staff would take steps to stabilize him, and if the placement of the bullet wounds was not life-threatening, surgery might be postponed at that point. If, on the other hand, the bullet was in the torso and damage to an organ was feared, then we would cut. And that, I’m afraid, having seen too many Lucio Fulci films, might literally be ‘opening a can of worms.’”

And what about the security guard in our scenario? He’s typical of the early victims in a lot of zombie stories: an unconscious and unresponsive patient brought to a hospital after being bitten by an unknown assailant. The victim presents with a rapidly spreading infection and lapses into a coma, demonstrating severe respiratory difficulty.

We know, having seen these films, that the victim is going to die and then reanimate as a zombie: and in these films the hospital is likely to become a slaughterhouse. But would that really be the way things played out?

The Zombie Factor

“You have to understand,” says Harris Grantham, “that no one at any point would be thinking ‘oh, this is a zombie’ or ‘this is supernatural.’ Even with the most bizarre and extreme symptoms we would all be reacting as if this is a standard medical crisis. Certainly it would have its unique and disturbing features, but everyone—and I mean
everyone
—would be treating this incident as if it were a disease, which is certainly what it would have to be.”

“New diseases and mutations of known diseases are regularly discovered,” says Dr. Natalie Mtumbo of the Word Health Organization. “I think it would be fair to say that even with all of the stress and pressure on the doctors and staff to try and understand this disease and determine a strategy for treatment there would be some doctors who would be viewing this as a ticket to a Fellowship, a grant, or maybe the Nobel Prize. This would be history in the making, and everyone in that surgical theater would know that.”

Grantham agrees wholeheartedly. “That’s not really as cynical a view as it sounds; not when you realize how much research depends on both grants and notoriety. If something big comes along it can draw in enough money to not only support the research but to stabilize the financial well-being of the entire hospital. Nobody comes out a loser in that scenario.”

Dr. Mtumbo adds, “Every single person exposed to the infected patient would be quarantined, and that includes the police, the witness, the tracker dogs—everyone. This would be too dangerous to allow for the slightest slip. We’ve
seen
what happens when a disease is not taken seriously. Visit Africa, look at the millions with AIDS and the firestorm that is tuberculosis. We’ve all made mistakes—doctors, health organizations, governments—and we have damn well learned from them. Never in history has the world’s medical professionals been so united in their stand against the spread of infectious diseases. And, yes, terrorism factors into that; this is the 21st century, so of course it does. So, what I’m saying here is that if a zombie plague happened then anyone who is even remotely suspected of being infected would be rounded up, isolated and studied. Very deeply studied. I doubt they would be going around biting people and spreading the disease.”

I asked my experts to speculate on how this scenario would play out if the disease spread as quickly as it does in
28 Days Later
and the remake of
Dawn of the Dead
.

Grantham was adamant. “Not going to happen. I could buy a reduced metabolic rate and some organ shutdown, which means I could
almost
buy the
Night of the Living Dead
zombies with some medical exceptions. At a stretch I could make a case for it; but the other plague doesn’t follow pathogenic spread patterns. It isn’t logical enough even to compete with the plague scenarios in the George Romero zombie movies.

“I never saw the American zombie films,” says Mtumbo, “but I did see
28 Days Later
in London, and I saw
28 Weeks Later
in Cape Town, South Africa. Though they were very frightening films, there were too many things in there that did not fit with what we know of science. In Cape Town, during my first year of residency, I went with some of my mates to a cinema that was showing
Shaun of the Dead
, which my friends said was very similar in many ways to the American zombie films. The dead in that were slower and it was clear that the infection required several hours to spread through the body before a person became a monster. Though I can still poke holes through that, it—at least—obeys some of the rules of disease pathology.”

This does bring up a new and potentially disastrous wrinkle. If the plague does not spread as quickly as it does in the more recent films, then there is actually a greater chance of it spreading farther before it’s detected. Dr. Lukacs explains, “I have to disagree that the outbreak would be contained within hospital walls. Every disease has an incubation period where the patient is asymptomatic. Even the common cold takes 2–3 days before making someone sick. For every patient admitted, there would be several infected patients still at large. And in this modern day, people can travel to just about any part of the globe within 24 hours.”

Grantham reluctantly agrees with this view. “I guess it depends on where you stand in terms of the zombie scenario. If we discount the ultra-fast spread of the disease as impossible, there are a couple of ways this could go. If the guard was brought into the hospital in a coma,
and
if the patient zero zombie was caught, then we might have nipped this in the bud. But the math gets complicated here, because if the zombie remains at large and continues to bite people, and if any of those people survive the bites and are not so severely injured that they fall into a coma, then they will be the most dangerous plague vectors. They might go to the hospital, receive treatment for the bite, and be released. The plague would be working inside of them, and if alarming symptoms don’t present quickly then they could potentially infect others. A kiss would probably do it, as would sexual contact. Possibly preparing foods, depending on the nature of the infection. If more than one person was similarly bitten then we could see a frightening pattern emerging. Not an aggressive attack like in
28 Days Later,
but a more quiet and insidious attack, like we saw with the spread of HIV.”

And if the zombie was caught?

“Once we had the zombie at the hospital, or in the morgue, that’s when useful alarm bells would ring. The physical examination and lab tests would show that we were dealing with a very dangerous and probably unknown disease. Having tried to bite the arresting police and hospital staff, and having already bitten a security guard, someone would be making the connection between bite and infection. The CDC would definitely be on speed-dial by this point, and we would use police and the media, as well as database searches of patients presenting to emergency rooms complaining of being bitten.”

Would that be enough?

Dr. Mtumbo is less optimistic on that point. “Well, there is a risk of a much greater spread. Not everyone listens to TV news or reads the paper, and many would miss the public service announcements. Not everyone would go to a hospital; and some who had been in for treatment and then went home might be unreachable. They could be going on a vacation or a business trip. They could go to bed and lapse into a coma; and if they died early enough in the night and reanimated early the next day they could attack their families, neighbors, or other people.”

“If we miss that early patient,” Grantham says, “then there would be a bigger spread of the disease and a greater potential for infection. But I’m still optimistic about our chances of getting ahead of the spread.”

Investigation of the source would be a top priority, he says. “One of the things I personally would want to know was where this initial patient came from and how and where he contracted the disease that was now in my hospital. If there was a disease of that level of virulence I would leave no stone unturned to find out. The fact that the man was brought in following an attack outside a medical facility would tell me a lot, and our own infectious disease investigators would be shoulder to shoulder with our lawyers as we tracked down who owned that facility and what the hell they were testing there. We’d call in Homeland Security and maybe FEMA. In short we would raise holy hell to find out what the hell they were testing out there that caused something like this. And if there was even the slightest whiff of cover-up we’d file ten kinds of suits against them and sue them back to the stone age…and the Fed would have our back, too, providing they hadn’t already kicked down the door. Something like this smells like bioterrorism if you sniff it the right way, and I can just imagine how much OHS
³
would want to put something big in their ‘win’ column. Global pandemic? Not on my watch, and not on the watch of anyone at OHS who wanted to stay employed. Wrath of God would be nothing compared to what would hit that research center, believe me.”

J
UST THE
F
ACTS

Mad Zombie Disease

So…what then could both destroy higher brain functions while at the same time keeping the central nervous system and some minimal organ functions operating? Ah…now that is the question.

Most of the zombie stories talk about a virus or bacteria. In Max Brooks’s
Zombie Survival Guide
and
World War Z
it’s
Solenum
; in
Resident Evil
it’s the T-Virus; and according to Sean Michael Ragan, a biochemist from the University of Texas at Austin, it’s “the Romero-Fulci Disese.”
⁴